Padua Prediction Score for Risk of VTE

• Many of the patients who developed VTE had active cancer or were older.
• However, this paper does demonstrate an overall lack of appropriate thromboprophylaxis in patients where the benefit may outweigh the risk.
• In the appropriate setting when a physician is already considering thromboprophylaxis for a patient considered high risk for VTE, a Padua score of ≥4 has the potential to support their clinical gestalt.

For patients admitted to a medical floor:

• Padua Score <4: Low risk of VTE.
  • Thromboprophylaxis should be considered on a case-by-case basis.
• Padua Score ≥4: High risk of VTE.
  • Thromboprophylaxis (i.e. heparin / enoxaparin) is recommended for non-pregnant patients without contraindications (major bleeding, low platelets, creatinine clearance <30 mL/min) who are >18 years.

• The Padua score is meant to risk stratify patients who have a potential risk for VTE, not to diagnose VTE.
• If deemed appropriate, anticoagulation should not be withheld from patients who require it as part of the treatment for their diagnosis.
• Prior to initiating any anticoagulant therapy a patient’s bleeding risk should be evaluated.